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Hepatocellular Cancer pp 117–140Cite as

Use of Imaging Techniques to Screen for Hepatocellular Carcinoma

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Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Accurate detection, characterization, and staging of hepatocellular carcinoma (HCC) are among the most difficult challenges facing radiologists and other physicians caring for patients with chronic liver disease. Most HCCs occur within the cirrhotic liver, and the diffuse and focal abnormalities that characterize the cirrhotic liver often are difficult to differentiate by any imaging test. Nevertheless, cross-sectional imaging methods (sonography, computed tomography [CT], and magnetic resonance imaging [MRI]) are applied frequently in the evaluation and surveillance of patients with chronic liver disease, and much has been learned about the relative merits and accuracy of these tools. There are substantial variations among investigations regarding recommendations for the choice and timing of imaging studies, many of which reflect the relative geographic prevalence of HCC and the availability and expense of imaging tests, as well as the enthusiasm and expertise of the interpreting physicians. This chapter reviews the current knowledge and published recommendations for imaging surveillance of chronic liver disease and presents our approach at the University of Pittsburgh Medical Center.

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References

  1. Ohtomo K, Baron RL, Dodd GD III, Federle MP. Confluent hepatic fibrosis in advanced cirrhosis: appearance at CT. Radiology 1993;188:31–35.

    PubMed  CAS  Google Scholar 

  2. Ohtomo K, Baron RL, Dodd GD III, Federle MP. Confluent hepatic fibrosis in advanced cirrhosis: evaluation with MR. Radiology 1993;189:871–874.

    PubMed  CAS  Google Scholar 

  3. Murakami T, Nakamura H, Hoi S, et al. CT and MRI of siderotic regenerating nodules in cirrhotic liver. J Comput Assist Tomogr 1992;16:578–582.

    Article  PubMed  CAS  Google Scholar 

  4. Ohtomo K, Stoi Y, Ohtomo Y, et al. Regenerating nodules of liver cirrhosis: MR imaging with pathologic correlation. AJR Am J Roentgenol 1990;154:505–507.

    PubMed  CAS  Google Scholar 

  5. Sakamoto M, Hirohashi S, Shimosato Y. Early stages of multistep hepatocarcinogenesis: adenomatous hyperplasia and early hepatocellular carcinoma. Hum Pathol 1991;22:172–178.

    Article  PubMed  CAS  Google Scholar 

  6. Takayama T, Makuuchi M, Hirohashi S, et al. Malignant transformation of adenomatous hyperplasia to hepatocellular carcinoma. Lancet 1990;336:1150–1153.

    Article  PubMed  CAS  Google Scholar 

  7. Dodd GD III, Baron RL, Oliver JH III, Federle MP. Spectrum of imaging findings of the liver in end-stage cirrhosis. Part II: focal abnormalities. AJR Am J Roentgenol 1999;173:1185–1192.

    PubMed  Google Scholar 

  8. Krinsky GA, Lee VS, Theise ND, et al. Hepatocellular carcinoma and dysplastic nodules in patients with cirrhosis: prospective diagnosis with MR imaging and explantation correlation. Radiology 2001;219:445–454.

    PubMed  CAS  Google Scholar 

  9. Lim JH, Kim CK, Lee WJ, et al. Detection of hepatocellular carcinoma and dysplastic nodules in cirrhotic livers: accuracy of helical CT in transplant patients. AJR Am J Roentgenol 2000;175:693–698.

    PubMed  CAS  Google Scholar 

  10. Tanaka S, Kitamura T, Fujita M, et al. Small hepatocellular carcinoma: differentiation from adenomatous hyperplastic nodule with color Doppler flow imaging. Radiology 1992;182:161–165.

    PubMed  CAS  Google Scholar 

  11. Bennett GL, Krinsky GA, Abitbol RJ, et al. Ultrasound detection of hepatocellular carcinoma and dysplastic nodules in patients with cirrhosis: correlation of pretransplant ultrasound findings and liver explant pathology in 200 patients [abstract]. Am J Roentgenol 2002;179:75–80.

    Google Scholar 

  12. Matsui O, Kadoya M, Kameyama T, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 1991;178:493–497.

    PubMed  CAS  Google Scholar 

  13. Ebara M, Ohto M, Waranabe Y, et al. Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies. Radiology 1986;159:371–377.

    PubMed  CAS  Google Scholar 

  14. Wilson SR, Burns PN. Liver mass evaluation with ultrasound: the impact of microbubble contrast agents and pulse inversion imaging. Semin Liver Dis 2001;21:147–159.

    Article  PubMed  CAS  Google Scholar 

  15. Federle MP, Blachar A. CT evaluation of the liver: principles and techniques. Semin Liver Dis 2001;21:135–146.

    Article  PubMed  CAS  Google Scholar 

  16. Beavers KL, Semelka RC. MRI evaluation of the liver. Semin Liver Dis 2001;21:161–194.

    Article  PubMed  CAS  Google Scholar 

  17. Kim T, Federle MP, Baron RL, Peterson MS, Kawamori Y. Discrimination of small hepatic hemangiomas from hypervascular malignant tumors smaller than 3cm with three-phase helical CT. Radiology 2001;219:699–706.

    PubMed  CAS  Google Scholar 

  18. Brancatelli G, Federle MP, Blachar A, Grazioli L. Hemangioma in the cirrhotic liver: diagnosis and natural history. Radiology 2001;219:69–74.

    PubMed  CAS  Google Scholar 

  19. Murakami T, Mochizaki K, Nakamura H. Imaging evaluation of the cirrhotic liver. Semin Liver Dis 2001;21:213–224.

    Article  PubMed  CAS  Google Scholar 

  20. Mori K, Yoshioka H, Itai Y, et al. Arterioportal shunts in cirrhotic patients: evaluation of the difference between tumorous and nontumorous arterioportal shunts on MR imaging with superparamagnetic iron oxide. AJR Am J Roentgenol 2000;175:1659–1664.

    PubMed  CAS  Google Scholar 

  21. Murakami T, Kim T, Takamura M, et al. Hypervascular hepatocellular carcinoma: detection with double arterial phase multi-detector row helical CT. Radiology 2001;218:763–767.

    PubMed  CAS  Google Scholar 

  22. Kadoya M, Matsui O, Takashima T, Nonomura A. Hepatocellular carcinoma: correlation of MR imaging and histologic findings. Radiology 1992;183:819–825.

    PubMed  CAS  Google Scholar 

  23. Murakami T, Baron RL, Federle MP, et al. Hepatocellular carcinoma: MR imaging with mangafodipir trisodium (Mn-DPDP). Radiology 1996;2000:69–77.

    Google Scholar 

  24. Miller WJ, Federle MP, Campbell WL. Diagnosis and staging of hepatocellular carcinoma: comparison of CT and sonography in 36 liver transplantation patients. AJR Am J Roentgenol 1991;157:303–306.

    PubMed  CAS  Google Scholar 

  25. Peterson MS, Baron RL, Marsh JW Jr, et al. Pretransplant surveillance for possible hepatocellular carcinoma in patients with cirrhosis: epidemiology and CT-based tumor detection rate in 430 cases with surgical pathologic correlation. Radiology 2000;217:743–749.

    PubMed  CAS  Google Scholar 

  26. Arii S, Tobe T. Results of surgical treatment. Follow-up study by liver cancer study group of Japan. In: Primary Liver Cancer in Japan (Tobe T, et al., eds.), Springer-Verlag, Tokyo, 1992, pp. 243–255.

    Google Scholar 

  27. Mor E, Kaspa RT, Sheiner P, Schwartz M. Treatment of hepatocellular carcinoma associated with cirrhosis in the era of liver transplantation. Ann Intern Med 1998;15:129:643–653.

    Google Scholar 

  28. Achkar JP, Araya V, Baron RL, et al. Undetected hepatocellular carcinoma: clinical features and outcome after liver transplantation. Liver Transpl Surg 1998;4:477–482.

    Article  PubMed  CAS  Google Scholar 

  29. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona 2000 EASL conference. J Hepatol 2001;35:421–430.

    Article  PubMed  CAS  Google Scholar 

  30. Collier J, Sherman M. Screening for hepatocellular carcinoma. Hepatology 1998;27:273–378.

    Article  PubMed  CAS  Google Scholar 

  31. Okuda K. Early recognition of hepatocellular carcinoma. Hepatology 1986;6:729–738.

    Article  PubMed  CAS  Google Scholar 

  32. Ebara M, Ohto M, Shinagawa T, et al. Natural history of minute hepatocellular carcinoma smaller than three centimeters complicating cirrhosis: a study in 22 patients. Gastroenterology 1986;90:289–298.

    PubMed  CAS  Google Scholar 

  33. Barbara L, Benzi G, Gaiani S, et al. Natural history of small untreated hepatocellular carcinoma in cirrhosis: a multivariate analysis of prognostic factors of tumor growth rate and patient survival. Hepatology 1992;16:132–137.

    Article  PubMed  CAS  Google Scholar 

  34. Kaneko S, Unoura M, Kobayashi K. Early detection of hepatocellular carcinoma. In: Liver Cancer (Ohuda K, Tabor E, eds.), Churchill Livingstone, New York, 1997, pp. 393–406.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA

    Michael P. Federle MD

Authors
  1. Michael P. Federle MD
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Editor information

Editors and Affiliations

  1. Liver Cancer Center, Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA

    Brian I. Carr MD, FRCP, PhD

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© 2005 Humana Press Inc., Totowa, NJ

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Federle, M.P. (2005). Use of Imaging Techniques to Screen for Hepatocellular Carcinoma. In: Carr, B.I. (eds) Hepatocellular Cancer. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59259-844-1_5

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  • DOI: https://doi.org/10.1007/978-1-59259-844-1_5

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-125-7

  • Online ISBN: 978-1-59259-844-1

  • eBook Packages: MedicineMedicine (R0)

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